NPI | 1427684927 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NM SLP6660) |
Additional Taxonomies | 314000000X Skilled Nursing Facility |
Enumeration Date | 2020-03-16 |
Last Update Date | 2021-05-14 |